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Purpose: Rhino-orbital-cerebral mucormycosis (ROCM) is the most common presentation of mucormycosis. Sinonasal–orbital debridement with exenteration is a life-saving procedure in ROCM patients in view of severe involvement of sinuses and the eyeball. Following the second wave of coronavirus disease 2019 (COVID-19), there was a massive surge in mucormycosis cases in India in post-COVID-19 patients. Of over 300 cases of mucormycosis admitted in our hospital, many underwent exenteration and these specimens were evaluated histopathologically, where fat necrosis was found to be a prominent finding. The spectrum of fat necrosis in ROCM in orbital fat has not been described in literature. Hence, we sought to evaluate the significance and spectrum of orbital fat necrosis in ROCM. Methods: This 3-month retrospective study included 15 cases of ROCM which underwent exenteration. Clinical data, radiologic details, and histopathologic findings were tabulated. Sections were also subjected to Periodic acid Schiff (PAS) and Gomori’s methenamine silver (GMS) stains for confirming the fungus. Results: All 15 cases showed fat stranding on computed tomography (CT) scan. On histopathologic examination, various tissue reaction patterns observed included acute/chronic inflammatory infiltrate, suppurative granulomas with giant cells, coagulative and fat necrosis, broad aseptate fungal hyphae with or without angioinvasion, and neural invasion. Fungal hyphae were confirmed with PAS and GMS stains. The spectrum of fat necrosis observed in all the cases included 1) acute necrotizing fat necrosis, 2) ghost adipocytes with or without saponification, and 3) crystalline/gouty fat necrosis. Conclusion: Fat necrosis is a significant finding in ROCM, both on CT scan and histopathology. All three patterns of fat necrosis may be observed simultaneously in a case of ROCM.

Purpose: Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations. Materials and Methods:Materials and Methods: A 56-item questionnaire survey on NOA diagnosis and management was conducted globally from July to September 2022. This paper focuses on part 1, evaluating NOA diagnosis. Data from 367 participants across 49 coun-tries were analyzed descriptively, with a Delphi process used for expert recommendations. Results:Results: Of 336 eligible responses, most participants were experienced attending physicians (70.93%). To diagnose azoosper-mia definitively, 81.7% requested two semen samples. Commonly ordered hormone tests included serum follicle-stimulating hormone (FSH) (97.0%), total testosterone (92.9%), and luteinizing hormone (86.9%). Genetic testing was requested by 66.6%, with karyotype analysis (86.2%) and Y chromosome microdeletions (88.3%) prevalent. Diagnostic testicular biopsy, distinguishing obstructive azoospermia (OA) from NOA, was not performed by 45.1%, while 34.6% did it selectively. Differ-entiation relied on physical examination (76.1%), serum hormone profiles (69.6%), and semen tests (68.1%). Expectations of finding sperm surgically were higher in men with normal FSH, larger testes, and a history of sperm in ejaculate. Conclusions:Conclusions: This expert survey, encompassing 367 participants from 49 countries, unveils congruence with recommended guidelines in NOA diagnosis. However, noteworthy disparities in practices suggest a need for evidence-based, international consensus guidelines to standardize NOA evaluation, addressing existing gaps in professional recommendations.

Background and Aims: Precise airway management is vital in thoracic surgeries to ensure patient safety and optimal outcomes. Choosing the correct double-lumen tube (DLT) size is challenging, as it typically relies on height, gender and subjective experience. This study investigates using ultrasonography (USG) and computed tomography (CT) to measure cricoid cartilage diameter for objective DLT sizing. Methods: In a randomised study, 120 adult patients undergoing elective thoracic surgery were randomised to three groups: Group A (DLT size determined by USG), Group B (DLT size determined by CT) and Group C (DLT size determined by conventional methods based on height and gender). The primary outcome variable was the appropriateness of DLT size. Secondary outcome variables were the degree of lung collapse and sore throat. Student’s t-test and ꭓ2 test were used to analyse continuous and dichotomous variables, respectively. Results: DLT sizing based on cricoid cartilage diameter improved the accuracy, with inappropriate sizes found in 25% in the conventional group, 5% in the USG group and 2.5% in the CT group (P < 0.05). Lung collapse was better in the USG (excellent in 92.5%) and CT (95%) groups compared to the conventional group (70%) (P < 0.05). Moderate sore throat was higher in the conventional group (37.5%) compared to the USG (5%) and CT groups (7.5%). Conclusion: The study demonstrates that USG- and CT-guided measurements of cricoid cartilage diameter are reliable and effective methods for determining DLT size in thoracic surgery compared to conventional methods.

Abstract What nutrient supply options can ensure maximum productivity and optimize the nutrient uptake of rice–wheat system (R-W system)? an experiment started in the year 1998 (19-year-old) to examine the impact of optimal nutrient supply (NS) strategies to maximize crop productivity and nutritional security in R-W system. To determine the best nutrient management strategies (BNMS), seven different NS methods were tested. These included (organic and mineral fertilizers), as well as combinations such as integrated plant nutrition system (IPNS), IPNS + B (berseem), and IPNS + C (cowpea), with the aim of enhancing the productivity and nutrient absorption of R-W system. Results showed that rice grain yield notably wide-ranging from 1.61 to 5.81 t ha−1 under different NS options and highest rice grain yield (mean of 19 years) was observed at IPNS + C (5.81 t ha−1), which was at par with IPNS (5.79 t ha−1), STCR (soil test crop response) (5.76 t ha−1) and IPNS + B (5.67 t ha−1) followed by 100% recommended dose fertilizer NPK (4.41 t ha−1), which equality with OF (organic farming) (4.04 t ha−1) and lowest was recorded in control plot (1.61 t ha−1). Wheat grain yield varied significantly from 1.43 to 5.86 t ha−1 under different NS options. The highest yield (mean of 19 years) was observed in treatments IPNS + B (5.86 t ha−1), IPNS (5.77 t ha−1), IPNS + C (5.48 t ha−1), and STCR (5.45 t ha−1), followed by OF at 4.49 t ha−1, NPK at 3.76 t ha−1, with the lowest in the control plot at 1.43 t ha−1. Additionally, total phosphorus and sulfur accumulation in rice (grain: 8.41 to 39.09 kg ha−1; straw: 6.02 to 23.54 kg ha−1) varied significantly across nutrient supply treatments. Overall, adoption of IPNS integration with legumes (IPNS + B and IPNS + C), can significantly improve productivity and nutrient accumulation in R-W systems. Incorporating legumes into farming practices is advised for sustained productivity and nutritional benefits.

Background: Schizophrenia is a severe psychiatric condition that affects approximately 24 million people worldwide. The complex pathophysiology of schizophrenia presents various challenges for researchers and doctors. Therefore, it is crucial to curate robust pharmacotherapy for patients with schizophrenia to ease their symptoms. Establishing proper standards for patient care requires an ammunition of research studies done on the disease and its therapy, upon which health-care practitioners can rely for future patient care. Unfortunately, there is a void of adequate research studies done on understanding the prescription patterns of schizophrenia in India, especially in rural areas. To improve patient outcomes, there is a need for increased research on this particular subject. Aim: The aim of this study was to assess the prescription pattern of antipsychotics in patients with schizophrenia at a tertiary care hospital in rural Karnataka. Setting and Design: This is an observational study carried out in MVJ Medical College and Research Hospital, Bengaluru, India. Materials and Methods: The study included a total of 139 inpatients, regardless of their age and sex, who had been diagnosed with schizophrenia. The study was conducted for a period of 6 months, from February 2022 to July 2022. Data collection involved a case record form (CRF) designed for assessing treatment patterns. An investigator was assigned to the Department of Psychiatry, where patients with schizophrenia were discovered and after reviewing their medication chart, necessary data were filled into the CRF. The obtained data were then compiled and assessed. Results: Paranoid schizophrenia was the major subclass (90.0%). The prescription pattern showed that second-generation antipsychotics (SGAs) were prescribed more than first-generation antipsychotics (FGAs), 112 (81.29%) and 41 (29.5%) prescriptions, respectively. In SGAs, tablet olanzapine received the most prescriptions which was 42 (30.22%). Tablet haloperidol was the major FGA to be prescribed receiving 18 prescriptions (12.95%). This study also included the assessment of combination drugs which showed that tablet risperidone + tablet trihexyphenidyl was the most prescribed combination drug 118 (78.43%). Conclusion: Our study showed that our findings aligned with several similar studies and also differed from a few, underscoring the need for further research and individualized treatment approaches to manage this complex psychiatric disorder.

Abstract Recent advancements in translational gut microbiome research have revealed its crucial role in shaping predictive healthcare applications. Herein, we introduce the Gut Microbiome Wellness Index 2 (GMWI2), an enhanced version of our original GMWI prototype, designed as a standardized disease-agnostic health status indicator based on gut microbiome taxonomic profiles. Our analysis involves pooling existing 8069 stool shotgun metagenomes from 54 published studies across a global demographic landscape (spanning 26 countries and six continents) to identify gut taxonomic signals linked to disease presence or absence. GMWI2 achieves a cross-validation balanced accuracy of 80% in distinguishing healthy (no disease) from non-healthy (diseased) individuals and surpasses 90% accuracy for samples with higher confidence (i.e., outside the “reject option”). This performance exceeds that of the original GMWI model and traditional species-level α-diversity indices, indicating a more robust gut microbiome signature for differentiating between healthy and non-healthy phenotypes across multiple diseases. When assessed through inter-study validation and external validation cohorts, GMWI2 maintains an average accuracy of nearly 75%. Furthermore, by reevaluating previously published datasets, GMWI2 offers new insights into the effects of diet, antibiotic exposure, and fecal microbiota transplantation on gut health. Available as an open-source command-line tool, GMWI2 represents a timely, pivotal resource for evaluating health using an individual’s unique gut microbial composition.

Introduction: Although debatable, prophylactic antibiotics may be required for patients undergoing cholecystectomy for symptomatic gallstone disease with certain associated risk factors. Our study aimed to perform a non-randomised prospective comparative trial evaluating a single-dose pre-operative antibiotic versus a triple-dose prophylactic post-operative antibiotic in patients with symptomatic uncomplicated cholelithiasis undergoing laparoscopic cholecystectomy. Methodology: This study was a non-randomised prospective comparative study in a single institution. Two hundred patients were enrolled and allocated to two groups. Group A patients were given a single dose of pre-operative prophylactic antibiotic, and Group B patients received a triple dose of prophylactic antibiotic therapy. We also studied the bacteriological profile of bile in all the patients using bile culture and antibiotic sensitivity, and we analysed their association with post-operative surgical site infection (SSI). Results: All the patients were followed up on post-operative days 7 and 30. On post-operative day 7, 2% of patients in Group A and 1% of patients in Group B were found to have SSI, and no statistically significant difference in SSI between the two groups was noted (P = 0.558). On post-operative day 30, no patient was found to have a SSI in either of the two groups. Moreover, post-operative bile culture was obtained in all the cases, and 6% of patients had a positive bile culture. However, none of them developed SSIs on post-operative day 7. Conclusion: A single-dose pre-operative antibiotic is as effective as three perioperative doses in preventing SSI in laparoscopic cholecystectomy for symptomatic, uncomplicated gallstone disease. Our study did not associate port-site SSI with a positive bile culture.

Abstract Two‐dimensional (2D) antiferromagnetic (AFM) semiconductors are promising components of opto‐spintronic devices due to terahertz operation frequencies and minimal interactions with stray fields. However, the lack of net magnetization significantly limits the number of experimental techniques available to study the relationship between magnetic order and semiconducting properties. Here, they demonstrate conditions under which photocurrent spectroscopy can be employed to study many‐body magnetic excitons in the 2D AFM semiconductor NiI2. The use of photocurrent spectroscopy enables the detection of optically dark magnetic excitons down to bilayer thickness, revealing a high degree of linear polarization that is coupled to the underlying helical AFM order of NiI2. In addition to probing the coupling between magnetic order and dark excitons, this work provides strong evidence for the multiferroicity of NiI2 down to bilayer thickness, thus demonstrating the utility of photocurrent spectroscopy for revealing subtle opto‐spintronic phenomena in the atomically thin limit.

Background: Rituximab infusion and dexamethasone-cyclophosphamide pulse (DCP) are the two most popular regimens used in pemphigus vulgaris (PV) in India. Objective: The present study compared the clinical efficacy of rituximab and DCP in Indian PV patients and their effects on serum Th1,2, and 17 cytokine levels. Materials and Methods: A total of 37 patients received DCP (Group A, n = 22) or rituximab (Group B, rheumatoid arthritis protocol (n = 15)) as per patients’ preference. They were monitored for clinical response, adverse events (AEs), changes in serum anti-desmoglein-1,3 antibody titers and Th1,2 and 17 cytokine levels at baseline and weeks 20 and 52. Results: The proportion of patients attaining disease control, remission, and relapse in groups A and B were 82% and 93%; 73% and 93%; and 27% and 50%, respectively, after a median duration of 2 months each for disease control; 4 and 4.5 months for remission; and 5 and 7 months for relapse post remission. The musculoskeletal AEs were the highest in the two groups. Significant and comparable decreases in anti-dsg1 and 3 titers from baseline to weeks 20 and 52 were observed in both groups. Th1 and Th17 cytokine levels decreased, while Th2 cytokines increased post-treatment in both groups. However, no correlation was found between change in body surface area of involvement by PV and anti-dsg titers and cytokine levels before and after therapy in both groups. Conclusion: Comparable clinical efficacy between DCP and rituximab was observed.

Purpose: This study aims to establish DROL (disruption of retinal outer layers), PROS (photoreceptor outer segment length), SND (subfoveal neuroretinal detachment), and hyperreflective walls of foveal cystoid spaces (HRW) as optical coherence tomography (OCT) biomarkers and predictors of central macular thickness (CMT) and visual acuity in diabetic macular edema (DME) treated with intravitreal ranibizumab (IVR). Methods: In this prospective, interventional study performed at a tertiary care center over a span of 1 year from December 2021 to December 2022, 50 eyes of 46 patients of DME were included. Visual acuity and spectral domain OCT imaging were performed at baseline. Using inbuilt calipers on SD-OCT, the horizontal extent of DROL and the vertical extent of PROS were measured manually. SND and HRW were assessed qualitatively. IVR was administered and patients were followed up at 4, 8, and 12 weeks. Results: The eyes without DROL had statistically significant (P < 0.05) lesser CMT and better BCVA (best-corrected visual acuity) (P < 0.05) after pro re nata injection of IVR. There was a positive correlation between the extent of baseline DROL with final CMT (P < 0.05) and final logMAR BCVA (P > 0.05), whereas negative correlation with the extent of baseline PROS with final CMT (P < 0.05) and final logMAR BCVA (P > 0.05). The presence of HRW and SND predicted non-resolution of CMT and worse visual acuity after treatment with IVR in DME . Conclusion: DROL, PROS, SND, and hyperreflective walls of foveal cystoid spaces may be utilized as qualitative as well as quantitative biomarkers to predict the post-treatment CMT and visual acuity in DME.

Abstract The precise design of single-atom nanozymes (SAzymes) and understanding of their biocatalytic mechanisms hold great promise for developing ideal bio-enzyme substitutes. While considerable efforts have been directed towards mimicking partial bio-inspired structures, the integration of heterogeneous SAzymes configurations and homogeneous enzyme-like mechanism remains an enormous challenge. Here, we show a spatial engineering strategy to fabricate dual-sites SAzymes with atomic Fe active center and adjacent Cu sites. Compared to planar Fe–Cu dual-atomic sites, vertically stacked Fe–Cu geometry in FePc@2D-Cu–N–C possesses highly optimized scaffolds, favorable substrate affinity, and fast electron transfer. These characteristics of FePc@2D-Cu–N–C SAzyme induces biomimetic O2 activation through homogenous enzymatic pathway, resembling functional and mechanistic similarity to natural cytochrome c oxidase. Furthermore, it presents an appealing alternative of cytochrome P450 3A4 for drug metabolism and drug–drug interaction. These findings are expected to deepen the fundamental understanding of atomic-level design in next-generation bio-inspired nanozymes.

Background: The burden of over 300 million individuals living with hypertension in India is increasing steadily. Most current guidelines recommend initial combination therapy for effective blood pressure (BP) control. However, there is no randomised evidence to inform which combinations to use in the South Asian population, who account for over one-quarter of the world's population. Methods: This multi-centre, single-blind, randomised, three-arm trial recruited men and women aged 30–79 years with hypertension. The trial compares the efficacy of commonly recommended single pill combinations (SPCs) of three drug classes – calcium channel blocker (amlodipine), ACE inhibitor (perindopril), and a thiazide-like diuretic (indapamide). The primary objective is to determine the most effective two-drug combination, initially at starting doses with forced up-titration at 2 months, in reducing 24-h ambulatory systolic blood pressure (ASBP) at 6 months. The trial has 85 % power to detect a difference of 3 mmHg in 24-h ASBP amongst the groups.Participant recruitment took place from August 2022 to February 2024. Baseline results: The 1981 participants (42.0 % women) enrolled had a mean age of 52.1 (SD 11.3) years and a mean body mass index of 26.5 (SD 4.2) kg/m2. 58.1 % of participants had a previous diagnosis of hypertension and 18.6 % of participants were known to diabetes. The mean ASBP was 135.6 (SD 17.0) mmHg, and the mean ambulatory diastolic BP was 84.5 (SD 10.9) mmHg. Conclusion: The TOPSPIN trial is the first randomised evaluation of commonly used BP-lowering combination therapies in a South Asian population. The results have potentially significant implications for choosing first-line antihypertensive agents among Indians and the South Asian diaspora.

Hard Carbon is the most widely used negative electrode material for sodium-ion batteries today. Achieving high storage capacity and increasing the plateau capacity, as opposed to the sloping profile, are crucial for enhancing energy density of the full cells. While several publications address the synthesis of hard carbon, the economic viability for commercial scale-up hinges on the choice of precursors. In this study, we report the electrochemical properties of hard carbon derived from two biomass precursors, sugarcane waste (bagasse) and corn waste, and compare their performances with commercially available hard carbon. The hard carbon derived from bagasse delivers a capacity of 307 mAh/g at C/10 rate and retains approximately 234 mAh/g at 3C discharge rate. We integrate surface area, pore size distribution, Raman spectroscopy, small-angle X-ray and neutron scattering data to elucidate the sodium storage mechanism in these hard carbon samples. Correlated graphitic domains with hexagonal ordering along with fractal like agglomeration of the nanosheets are quantified. The high plateau capacity of the bagasse-derived hard carbon is attributed to the characteristic morphology and size distribution of the nanosheets and their nature of agglomeration.

Introduction Chemotherapy daycare units (CDU) routinely face difficulties, given the waiting time and work pressure. The study objectives include determining the feasibility of a multidisciplinary intervention in facilitating the growth in CDU bed utilization by ∼20%. Methods The quasi-experimental study was conducted during the period 1st May 2021 to 28th February 2022. The strategies of the healthcare improvement project are structured as per the Plan-Do-Study-Act (PDSA) cycle. ‘Lean thinking’ approach using the A3 sheet tool was applied, as its focus is on organization of processes. Benchmarking technique was used to attain more insight into the optimal performance levels. Results Plan phase: The tracks of CDU process were mapped using the ‘process flow diagram’ technique. The reasons for the perceived bed shortage and high work pressure were revealed by the Root cause analysis, which includes the 21 prioritized problem areas. Do phase: Various interventions were implemented in the domains of communication systems, developing standard operating protocols and human resource management. Study phase: 9 of the total 21 problem areas were cumulatively responsible for ∼80% of underutilization of CDU beds. Act phase: The planned intervention resulted in an increase in the proportion of CDU bed utilization from 60% (18-20 patients/day) to 75% (23-25 patients/day). Conclusion The PDSA cycle offered optimal structure to this efficiency improvement initiative. The project outcomes were enhanced by the combination of approaches such as lean thinking and benchmarking.

Abstract Mo2C is an excellent electrocatalyst for hydrogen evolution reaction (HER). However, Mo2C is a poor electrocatalyst for oxygen evolution reaction (OER). Herein, two different elements, namely Co and Fe, are incorporated in Mo2C that, therefore, has a finely tuned electronic structure, which is not achievable by incorporation of any one of the metals. Consequently, the resulting electrocatalyst Co0.8Fe0.2–Mo2C‐80 displayed excellent OER catalytic performance, which is evidenced by a low overpotential of 214.0 (and 246.5) mV to attain a current density of 10 (and 50) mA cm−2, an ultralow Tafel slope of 38.4 mV dec−1, and long‐term stability in alkaline medium. Theoretical data demonstrates that Co0.8Fe0.2–Mo2C‐80 requires the lowest overpotential (1.00 V) for OER and Co centers to be the active sites. The ultrahigh catalytic performance of the electrocatalyst is attributed to the excellent intrinsic catalytic activity due to high Brunauer–Emmett–Teller specific surface area, large electrochemically active surface area, small Tafel slope, and low charge‐transfer resistance.

Abstract Background and Aims Urban corporate sector relies heavily on workplace well‐being, with meditation being a potent stress reduction method that significantly enhances the quality of life (QoL) and wellness. The study aims to assess the effectiveness of meditation on wellness management among corporate employees in India. Methods The quasi‐experimental controlled study design was employed from May to June 2021, which assessed stress, QoL, and wellness indices (satisfaction with life, well‐being) with meditation practice as the intervention. The online questionnaire incorporates questions from the Depression, Anxiety, Stress Scale, World Health Organization (WHO) QoL Scale, Five‐item Satisfaction with Life scale and WHO‐5 Well‐being Index. A nonrandom sampling technique selected 146 and 74 subjects in the intervention and control groups, respectively, among the employees of Star health‐ and allied insurance company. The data was analyzed using SPSS V27 (©IBM SPSS Statistics). The Wilcoxon signed rank test for the dependent groups, and Mann–Whitney U test for the independent groups (between subjects) was performed. Results Among a total of 220 subjects who enrolled in the recruitment survey, 146 subjects underwent the intervention thus providing a response rate of 66.4%. For the intervention group, the difference (within group) in mean scores between baseline and endline assessment shows a reduction in stress (0.02) and significant improvement in QoL (0.21) and wellness indices (satisfaction with life: 0.21, well‐being: 0.24). The difference (between the experimental and control groups) in mean endline scores shows a decrease in stress (0.07), an increase in wellness indices (satisfaction with life: 0.12, well‐being: 0.23), and a significant change in the QoL (0.17). Conclusion Meditation intervention in corporate wellness programs enhances the QoL, wellness, and stress management, establishing the effectiveness of health profile‐raising ingenuities at the workplace.

Introduction and Objectives: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide and can progress to non-alcoholic steatohepatitis (NASH) and, ultimately, cirrhosis. Clostridioides difficile is the most common nosocomial cause of diarrhea and is associated with worse clinical outcomes in other liver diseases, including cirrhosis, but has not been extensively evaluated in concomitant NAFLD/NASH. Materials and Methods: We conducted a retrospective cohort study using the National Inpatient Sample database from 2015 to 2017. Patients with a diagnosis of CDI, NAFLD, and NASH were identified using International Classification of Diseases (Tenth Revision) codes. The outcomes of our study include length of stay, hospitalization cost, mortality, and predictors of mortality. Results: The CDI and NASH cohort had a higher degree of comorbidity burden and prevalence of peptic ulcer disease, congestive heart failure, diabetes mellitus, and cirrhosis. Patients with NASH and CDI had a significantly higher mortality rate compared to the CDI only cohort (mortality, 7.11 % vs. 6.36 %; P = 0.042). Patients with CDI and NASH were at increased risk for liver-related complications, acute kidney injury, and septic shock (P < 0.001) compared to patients with CDI only. Older age, intestinal complications, pneumonia, sepsis and septic shock, and liver failure conferred an increased risk of mortality among the CDI and NASH cohort. Conclusions: Patients with NASH had a higher rate of liver-related complications, progression to septic shock, and mortality rate following CDI infection compared to the CDI only cohort.

Acute kidney injury (AKI) disrupts energy metabolism. Targeting metabolism through AMP-activated protein kinase (AMPK) may alleviate AKI. ATX-304, a pan-AMPK activator, was evaluated in C57Bl/6 mice and tubular epithelial cell (TEC) cultures. Mice received ATX-304 (1 mg/g) or control chow for 7 days before cisplatin-induced AKI (CI-AKI). Primary cultures of tubular epithelial cells (TECs) were pre-treated with ATX-304 (20 µM, 4 h) prior to exposure to cisplatin (20 µM, 23 h). ATX-304 increased acetyl-CoA carboxylase phosphorylation, indicating AMPK activation. It protected against CI-AKI measured by serum creatinine (control 0.05 + 0.03 mM vs ATX-304 0.02 + 0.01 mM, P = 0.03), western blot for neutrophil gelatinase-associated lipocalin (NGAL) (control 3.3 + 1.8-fold vs ATX-304 1.2 + 0.55-fold, P = 0.002), and histological injury (control 3.5 + 0.59 vs ATX-304 2.7 + 0.74, P = 0.03). In TECs, pre-treatment with ATX-304 protected against cisplatin-mediated injury, as measured by lactate dehydrogenase release, MTS cell viability, and cleaved caspase 3 expression. ATX-304 protection against cisplatin was lost in AMPK-null murine embryonic fibroblasts. Metabolomic analysis in TECs revealed that ATX-304 (20 µM, 4 h) altered 66/126 metabolites, including fatty acids, tricarboxylic acid cycle metabolites, and amino acids. Metabolic studies of live cells using the XFe96 Seahorse analyzer revealed that ATX-304 increased the basal TEC oxygen consumption rate by 38%, whereas maximal respiration was unchanged. Thus, ATX-304 protects against cisplatin-mediated kidney injury via AMPK-dependent metabolic reprogramming, revealing a promising therapeutic strategy for AKI.

Abstract Background Dysbiosis of the gut microbiome is frequent in the intensive care unit (ICU), potentially leading to a heightened risk of nosocomial infections. Enhancing the gut microbiome has been proposed as a strategic approach to mitigate potential adverse outcomes. While prior research on select probiotic supplements has not successfully shown to improve gut microbial diversity, fermented foods offer a promising alternative. In this open-label phase I safety and feasibility study, we examined the safety and feasibility of kefir as an initial step towards utilizing fermented foods to mitigate gut dysbiosis in critically ill patients. Methods We administered kefir in escalating doses (60 mL, followed by 120 mL after 12 h, then 240 mL daily) to 54 critically ill patients with an intact gastrointestinal tract. To evaluate kefir’s safety, we monitored for gastrointestinal symptoms. Feasibility was determined by whether patients received a minimum of 75% of their assigned kefir doses. To assess changes in the gut microbiome composition following kefir administration, we collected two stool samples from 13 patients: one within 72 h of admission to the ICU and another at least 72 h after the first stool sample. Results After administering kefir, none of the 54 critically ill patients exhibited signs of kefir-related bacteremia. No side effects like bloating, vomiting, or aspiration were noted, except for diarrhea in two patients concurrently on laxatives. Out of the 393 kefir doses prescribed for all participants, 359 (91%) were successfully administered. We were able to collect an initial stool sample from 29 (54%) patients and a follow-up sample from 13 (24%) patients. Analysis of the 26 paired samples revealed no increase in gut microbial α-diversity between the two timepoints. However, there was a significant improvement in the Gut Microbiome Wellness Index (GMWI) by the second timepoint (P = 0.034, one-sided Wilcoxon signed-rank test); this finding supports our hypothesis that kefir administration can improve gut health in critically ill patients. Additionally, the known microbial species in kefir were found to exhibit varying levels of engraftment in patients’ guts. Conclusions Providing kefir to critically ill individuals is safe and feasible. Our findings warrant a larger evaluation of kefir’s safety, tolerability, and impact on gut microbiome dysbiosis in patients admitted to the ICU. Trial registration NCT05416814; trial registered on June 13, 2022.

Background: To document knowledge, attitude, and practice (KAP) patterns of diabetic patients regarding diabetic retinopathy (DR), to determine associations between them, and to identify barriers to compliance with follow up and treatment regimes. Method: This is a cross-sectional study including 504 participants who attended the outpatient department (OPD) of a tertiary care hospital in eastern India. The participants included diabetic patients and questionnaires were completed to collect information about their sociodemographic and healthcare characteristics. A Chi-square test and Pearson correlation test were performed to analyze the data. Results: A total of 504 participants were enrolled in the study, with a mean age of 62.84 ± 7.62 years and a mean diabetes duration of 12 ± 4.42 years. The majority (65.07%) of the participants had higher secondary education or above. Good knowledge, a positive attitude, and poor DR practices were observed in 56.34%, 68%, and 66.6% of participants, respectively. The most common barrier to complying with regular follow-up despite having knowledge were domestic issues (no family support, lack of transport). Conclusion: The study reported good knowledge and attitude about DR among type 2 diabetics with relatively poor eye-care practices. Therefore, it is recommended that a collaborative approach amongst primary care providers, ophthalmologists, diabetologists, and health policy makers is necessary to transform this good knowledge and attitude into good practices.

Purpose: To compare postoperative cosmesis, mydriasis, fundus visibility, and anterior chamber depth (ACD) in congenital and traumatic iris defects after single-pass four-throw pupilloplasty (SFTP). Settings and Design: Hospital-based non-randomized interventional study. Methods: SFTP was done along with phacoemulsification in six patients each with congenital and traumatic iris defects, and the patients were followed for a minimum period of 3 months. The postoperative pupil shape, size, mydriasis, and ACD were compared between the two groups. Results: Tissue approximation was successful in 11 out of 12 patients (91.7%), whereas it failed to do so in one patient with traumatic iris tear (8.3%). A central round pupil was attained in all six patients with congenital defects (group 1), whereas in the traumatic group (group 2), a central round pupil was attained in four cases. Group 1 did not show a significant reduction in horizontal pupil diameter, but group 2 had a significant reduction in pupil diameter postoperatively. Mydriasis and fundus visibility were satisfactory in all cases. There was a significant deepening of ACD in both groups. Conclusion: Traumatic mydriasis usually requires SFTP at two opposite poles to achieve a central pupil with a significant reduction in pupil size, whereas congenital coloboma requires SFTP to be done at the site of coloboma with occasional enlargement at the opposite pole if the pupil is eccentric.

Glioblastoma (IDH-wildtype) represents a formidable challenge in oncology, lacking effective chemotherapeutic or biological interventions. The metabolic reprogramming of cancer cells is a hallmark of tumor progression and drug resistance, yet the role of metabolic reprogramming in glioblastoma during drug treatment remains poorly understood. The dihydroorotate dehydrogenase (DHODH) inhibitor BAY2402234 is a blood–brain barrier penetrant drug showing efficiency in in vivo models of many brain cancers. In this study, we investigated the effect of BAY2402234 in regulating the metabolic phenotype of EGFRWT and EGFRvIII patient-derived glioblastoma cell lines. Our findings reveal the selective cytotoxicity of BAY2402234 toward EGFRWT glioblastoma subtypes with minimal effect on EGFRvIII patient cells. At sublethal doses, BAY2402234 induces triglyceride synthesis at the expense of membrane lipid synthesis and fatty acid oxidation in EGFRWT glioblastoma cells, while these effects are not observed in EGFRvIII glioblastoma cells. Furthermore, BAY2402234 reduced the abundance of signaling lipid species in EGFRWT glioblastoma. This study elucidates genetic mutation-specific metabolic plasticity and efficacy in glioblastoma cells in response to drug treatment, offering insights into therapeutic avenues for precision medicine approaches.

Purpose: Comparison of diagnostic capability of macular ganglion cell complex thickness vs. retinal nerve fiber layer (RNFL) thickness in patients of primary open-angle glaucoma (POAG). Settings and Design: This cross-sectional observational study was carried out between June 2021 and October 2022 at a tertiary care hospital in North India. Methods: A total of 118 eyes were included in the study with 30 control and the rest 88 eyes with POAG were divided into three groups based on visual field loss Group 1 (30 eyes): early field loss with mean deviation (MD) < −6 dB; Group 2 (30 eyes): moderate field loss with MD −6 to −12 dB; and Group 3 (28 eyes): severe field loss with MD > −12 dB. Optical coherence tomography (OCT) scans to measure RNFL loss and ganglion cell inferior plexiform layer (GCIPL) loss were taken for each patient. Statistical Analysis Used: Categorical variables were analyzed using either the Chi-square test or Fisher’s exact test. A receiver operating characteristics analysis was calculated to determine optimal cut-off values of superior, inferior, and average GCIPL and RNFL for determining the severity of field loss as compared to controls (30 normal eyes). Results: In the mild field loss group the sensitivity of superior, inferior, and average GCIPL was 86.7, 96.7, and 96.7%, respectively. Similarly, the specificity was 96.7, 93.3, and 100%, respectively. In the same group, the sensitivity of superior, inferior, and average RNFL was 70, 93, and 66%, respectively. Similarly, the specificity was 46.7, 83.3, and 70%, respectively. In the moderate and severe groups, the results were comparable. Conclusion: The sensitivity and specificity of GCIPL loss are significantly better than that of RNFL parameters in the mild field loss group.

Brown planthopper (BPH), Nilaparvata lugens (Stal 1854) is a destructive insect pest causing severe yield loss every year in rice (Oryza sativa L.) crop. An experiment was conducted during during kharif (rainy) seasons of 2021 and 2022 at the research farm of ICAR-Indian Agricultural Research Institute, New Delhi to study the effect of transplanting time and crop phenology on brown planthopper (BPH) incidence and spider population in rice. BPH and spider populations were recorded at different phenological stages in early, normal and late transplanted rice. Results showed that a significantly higher mean BPH population was observed in late transplanting in 2021 [54.00±5.31 per hill (nymphs and adults)] and 2022 (40.40±2.62 per hill) compared to normal and early tranplanting. Peak BPH population was observed at the heading (225.60±18.83 per hill) and milking stage (131.00±8.30 per hill) of late transplanted rice in 2021 and 2022, respectively. Likewise, more mean spider population was observed in late transplanting [1.87±0.11 per hill (adults) in 2021 and 2.38±0.08 per hill in 2022]. Two-way ANOVA showed a statistically significant interaction between transplanting time and crop phenology with regard to BPH incidence and spider population in both the years. The highest grain yield was recorded in early transplanted rice (36.08±0.75 q/ha; 35.06±0.49 q/ha) followed by normal (27.53±0.80 q/ha; 28.22±0.75 q/ha) and late transplanted rice crop (17.43±0.82 q/ha; 19.37±0.67 q/ha) respectively during two years. The early transplanted rice crop escaped the peak BPH incidence resulted in increased grain yield. The study demonstrated that both transplanting time and crop phenology influenced the BPH and spider populations.

Background Extreme hyperbilirubinemia leading to neurologic disability and death is disproportionately higher in low- and middle-income countries (LMIC) such as Bangladesh, and is largely preventable through timely treatment. In LMICs, an estimated half of all newborns are born at home and few receive screening or treatment for hyperbilirubinemia, leading to 6 million newborns per year who need phototherapy treatment for hyperbilirubinemia but are untreated. Household screening and treatment for neonatal hyperbilirubinemia with phototherapy administered by a trained community health worker (CHW) may increase indicated treatment for neonatal hyperbilirubinemia in comparison to the existing care system in Bangladesh. Methods 530 Bangladeshi women in their second or third trimester of pregnancy from the rural community of Sakhipur, Bangladesh will be recruited for a cluster randomized trial and randomized to the intervention arm — home screening and treatment for neonatal hyperbilirubinemia — or the comparison arm to receive usual care. In the intervention arm, CHWs will provide mothers with two prenatal visits, visit newborns by 2 days of age and then daily for 3 days to measure transcutaneous bilirubin (TcB) and monitor for clinical danger signs. Newborns without danger signs but with a TcB above the treatment threshold, but >15 mg/dL will be treated with light-emitting diode (LED) phototherapy at home. Newborns with danger signs or TcB ≥15 mg/dL will be referred to a hospital for treatment. Treatment rates for neonatal hyperbilirubinemia in each arm will be compared. Conclusion This study will evaluate the effectiveness of CHW-led home phototherapy to increase neonatal hyperbilirubinemia treatment rates in rural Bangladesh. LMICs are expanding access to postnatal care by using CHWs, and our work will give CHWs a curative treatment option for neonatal hyperbilirubinemia. Similar projects in other LMICs can be pursued to dramatically extend healthcare access to vulnerable newborns with hyperbilirubinemia.

The rise of “new economic statecraft”—intervention in trade and investment for foreign policy reasons—is increasingly threatening the stability of the global economic system. Building on previous work, we consider the types of intervention we have seen, classifying state measures as behind the border, at the border, and beyond the border. In addition, in the past, we have focused on understanding variation in new forms of economic statecraft through a five-factor model. This paper's central goal is to evaluate alternatives for constraining economic statecraft via institutional approaches. To this end, we draw on an analytical classification framework to theoretically and empirically analyze both sectoral and overall bilateral, minilateral, and multilateral institutional approaches to glean lessons for the management of new economic statecraft.

Background & aimsPrevious studies have examined the effects of metabolic syndrome (MetS) rather than its severity on race and ethnic disparities in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). We used the MetS severity score, a validated sex-race-ethnicity-specific severity measure, to examine the effects of race/ethnicity on the association between MetS severity and MASLD.MethodsThis study included 10,605 adult participants from the Third National Health and Nutrition Examination Survey. The MASLD diagnosis was based on ultrasound findings in patients without excessive alcohol intake or other liver diseases. MetS severity Z-scores were calculated and stratified into four categories low (1st-50th), moderate (>50th-75th), high (>75th-90th), and very high (>90th+)]. Multivariable adjusted logistic regression models with complex survey methods were used to test the effect of MetS severity on MASLD.ResultsThe age-adjusted MASLD prevalence was 17.4%, 25.7%, 42.5, and 54.9% in adults with mild, moderate, high, and very high MetS severities, respectively (P-trend ConclusionsRacial/ethnic disparities in MetS severity play a pivotal role in the risk of MASLD. Our findings highlight the potential clinical utility of the MetS severity score in identifying at-risk individuals, which will help guide targeted prevention and tailoring management strategies to mitigate the MASLD burden.

Dedicated to Dr. Rama P. Tripathi, Former Chief Scientist at CSIR-Central Drug Research Institute, Lucknow, India, for his extraordinary contribution to “Drug development against Tuberculosis”

Surface-active ionic liquids (SAILs) are of tremendous interest in recent times due to their improved application in the field of food, detergent, and health. The modulated fluorescence behavior of an intramolecular charge transfer (ICT) probe, trans‐ethyl‐p‐(dimethylamino) cinnamate (EDAC), in presence of five different SAILs with varying head groups (viz. imidazolium, pyridinium, and morpholinium) and different alkyl chain length (decyl, dodecyl, and tetradecyl) was monitored by steady state and time-resolved fluorescence spectroscopy. Extreme sensitivity of EDAC fluorescence was used to characterize different physicochemical properties of the SAILs, including critical micelle concentration, static polarity, and empirical solvent polarity scale, ET(30) of the microenvironment. The estimated parameters are in good agreement with the literature reports and measured independently from other complimentary experiments discussed here. Time‐resolved fluorescence experiments show a significant retardation in different nonradiative decay channels of EDAC, when compared to that in aqueous phase, indicating a preferential association of the probe in presence of SAILs. The results indicate that the physicochemical properties of SAILs can be tuned by controlling the nature of both the cations and as well as the chain length of the alkyl group. These properties also show significant modulation in solutions with varying SAIL concentration, particularly in the pre- and post-micellar region. The results, particularly the surface-active properties and the self-assembly behavior presented in this study, are expected to provide new knowledge towards the design and development of novel SAILs with specific industrial and biological applications.

Abstract We previously proposed the Gut Microbiome Wellness Index (GMWI), a predictor of disease presence based on a gut microbiome taxonomic profile. As an application of this index for food science research, we applied GMWI as a quantitative tool for measuring the prebiotic effect of oligosaccharides. Mainly, in an in vitro anaerobic batch fermentation system, fructooligosaccharides (FOS), galactooligosaccharides (GOS), xylooligosaccharides (XOS), inulin (IN), and 2’-fucosyllactose (2FL), were mixed separately with fecal samples obtained from healthy adult volunteers. To find out how 24 h prebiotic fermentation influenced the GMWI values in their respective microbial communities, changes in species-level relative abundances were analyzed in the five prebiotics groups, as well as in two control groups (no substrate addition at 0 h and for 24 h). The GMWI of fecal microbiomes treated with any of the five prebiotics (IN (0.48 ± 0.06) > FOS (0.47 ± 0.03) > XOS (0.33 ± 0.02) > GOS (0.26 ± 0.02) > 2FL (0.16 ± 0.06)) were positive, which indicates an increase of relative abundances of microbial species previously found to be associated with a healthy, disease-free state. In contrast, the GMWI of samples without substrate addition for 24 h (–0.60 ± 0.05) reflected a non-healthy, disease-harboring microbiome state. Compared to the original prebiotic index (PI) and α-diversity metrics, GMWI provides a more data-driven, evidence-based indexing system for evaluating the prebiotic effect of food components. This study demonstrates how GMWI can be applied as a novel PI in dietary intervention studies, with wider implications for designing personalized diets based on their impact on gut microbiome wellness.

Abstract A prompt and modular copper(I)-catalyzed azide–alkyne cycloaddition ʼclickʼ approach has been exploited for the synthesis of galactose- and mannose-coated calixarene-cored G1 generation glycodendrimers. The developed calixarene glycodendrimers were characterized by using spectral techniques (1H NMR, 13C NMR and IR). In photophysical evaluation, UV and fluorescence spectra of the developed compounds were recorded in CH3CN/H2O.

Abstract Patients with rheumatoid arthritis (RA) can test either positive or negative for circulating anti-citrullinated protein antibodies (ACPA) and are thereby categorized as ACPA-positive (ACPA+) or ACPA-negative (ACPA−), respectively. In this study, we aimed to elucidate a broader range of serological autoantibodies that could further explain immunological differences between patients with ACPA+ RA and ACPA− RA. On serum collected from adult patients with ACPA+ RA (n = 32), ACPA− RA (n = 30), and matched healthy controls (n = 30), we used a highly multiplex autoantibody profiling assay to screen for over 1600 IgG autoantibodies that target full-length, correctly folded, native human proteins. We identified differences in serum autoantibodies between patients with ACPA+ RA and ACPA− RA compared with healthy controls. Specifically, we found 22 and 19 autoantibodies with significantly higher abundances in ACPA+ RA patients and ACPA− RA patients, respectively. Among these two sets of autoantibodies, only one autoantibody (anti-GTF2A2) was common in both comparisons; this provides further evidence of immunological differences between these two RA subgroups despite sharing similar symptoms. On the other hand, we identified 30 and 25 autoantibodies with lower abundances in ACPA+ RA and ACPA− RA, respectively, of which 8 autoantibodies were common in both comparisons; we report for the first time that the depletion of certain autoantibodies may be linked to this autoimmune disease. Functional enrichment analysis of the protein antigens targeted by these autoantibodies showed an over-representation of a range of essential biological processes, including programmed cell death, metabolism, and signal transduction. Lastly, we found that autoantibodies correlate with Clinical Disease Activity Index, but associate differently depending on patients’ ACPA status. In all, we present candidate autoantibody biomarker signatures associated with ACPA status and disease activity in RA, providing a promising avenue for patient stratification and diagnostics.

A modular and highly reliable click approach is applied for the expeditious synthesis of lactose- and galactose-coated calixarene-cored G1 and G2 generation glycodendrimers, respectively. The developed calixarene glycodendrimers have been characterized by using extensive spectral analysis including NMR (1H and 13C), MS, IR, and SEC data.

In this report, we present the case of vanishing bile duct syndrome in the setting of classical Hodgkin lymphoma. Vanishing bile duct syndrome was diagnosed retrospectively in this patient with Hodgkin lymphoma, who initially presented with a hepatic abnormality presumed to be drug induced. Vanishing bile duct syndrome is characterized by the disappearance of bile ducts, with the progressive damage resulting in cholestasis. Thus, nivolumab therapy was initiated for Hodgkin lymphoma, in place of the standard ABVD (Doxorubicin, bleomycin, vinblastine, dacarbazine) regimen, which resulted in autoimmune hemolytic anemia. Alternatively, GDP (gemcitabine, dexamethasone, and carboplatin) chemotherapy with protocol modification resulted in better tolerance and remission of Hodgkin lymphoma. Granulocyte colony-stimulating factor support and romiplostim supplement were provided to prevent chemotherapy-induced neutropenia and thrombocytopenia, respectively. Due to the deranged liver function in our case, we initially suspected the etiology as drug-induced cholestatic injury. While hepatic failure is the leading cause of mortality among patients with Hodgkin lymphoma-related vanishing bile duct syndrome, our case report suggests a complete remission of vanishing bile duct syndrome following an adequate treatment of Hodgkin lymphoma and an improvement in the hepatic function. To conclude, our report describes the rare case of vanishing bile duct syndrome which heralded the diagnosis of Hodgkin lymphoma, and the effective management of Hodgkin lymphoma which precedes the improvement of hepatic abnormality.

Abstract Background Colorectal cancer (CRC) is the second most mortality rate causing disease after lung cancer. Though there is a significant improvement in the treatment schedule offered to CRC. However, there is no notable decrease in terms of cases as well as death rate. Hence, there is an urgent need to discover novel cancer therapeutics to treat CRC. Since ancient times, the use of phytochemicals has drawn huge attention as chemo-preventive and chemotherapeutic agents. Earlier studies on Tinospora sinensis (TS) revealed the cytotoxic effect on human colorectal carcinoma (HCT-116) cells, yet the mechanism is to be uncovered. Therefore, the present study was designed to study the cell death mechanism of TS in HCT-116 cells. Method Different extracts such as n-hexane, ethyl acetate, and ethanol extracts from the root part of TS were prepared using a cold maceration process. The extracts were screened against cancer cell lines by methyl thiazoldiphenyltetrazolium bromide (MTT) assay. From the result, the most active extract was subjected to gas chromatography-mass spectrometry (GC-MS) and Fourier-Transform infrared spectroscopy (FTIR) analyses to identify the major constituents. Finally, the mechanism of cytotoxicity to cancer cells for the most active extract was evaluated using various experiments such as cell cycle analysis, Annexin-V assay, and Western blot. Results The results from the MTT assay indicated that the n-hexane extract of TS inhibits the growth of HCT-116 cells more effectively than other cancer cells like Henrietta Lacks cervical cancer cells (Hela), and Michigan cancer foundation-breast cancer (MCF-7). The GC-MS and FT-IR analyses revealed the presence of alkaloids in the n-hexane extract and were responsible for the apoptosis activity in HCT-cells via reactive oxygen species (ROS) generation, and phosphoinositide 3-kinase (PI3K)/ protein Kinase B (Akt)/ mammalian target of rapamycin (mTOR) down-regulation. Conclusion This study concludes that this finding is unique of its kind, and for the first time. The anticancer effect of TS root is specific to colon cancer cells (HCT-116). This distinctive finding helps the researchers to investigate further, and to identify a novel source for anti-colon cancer drug candidates in near future.

Purpose: To identify the pattern, distribution, and causes of ocular injuries among the security personnel participating in counterinsurgency operations (CIOps). Methods: This was a multicentric, retrospective review of chart records of patients reporting to three hospitals located in the geographic region affected by CIOps. The hospital registry was examined for all patients diagnosed with any type of ocular trauma between January 1, 2016, and December 31, 2019. A standardized proforma was filled out using the case records, and entries were validated. Results: A total of 131 ocular injuries fulfilled the criteria of the study. The mean age of the patients was 32.46 ± 10.2 years. All the patients were males. The causes of the injuries were explosive blasts in 60 eyes (45.80%), gunshot wounds in 15 eyes (11.42%), stone pelting in 16 eyes (12.21%), training-related causes in 26 eyes (29.84%), vehicular accidents in 13 eyes (9.92%), and battery blast in one eye (0.76%). Among the type of injuries, open globe injuries included 66 eyes (50.38%), closed globe injuries included 35 eyes (26.72%), isolated lid lacerations included 14 eyes (10.68%), and isolated chemical injury was seen in two eyes (1.52%). Optic nerve head avulsion was seen in two eyes (1.52%). Conclusion: The study revealed a considerable number of ocular injuries related to combat, with explosive bursts being the leading cause. The incidence of ocular injuries was found to be highest in zone 1. This study emphasizes the importance of the need for soldiers deployed in active CIOps regions to wear protective eyewear, such as ballistic goggles or military combat eye protection, to reduce the risk of ocular injuries.

Background: Narrow-band ultraviolet B (NB-UVB) is the standard therapy for vitiligo. Objective: The objective of this study is to compare the safety and clinical efficacy of a handheld NB-UVB comb device with the standard whole-body NB-UVB therapy in localized stable vitiligo. Materials and Methods: Thirty-one vitiligo patients were allocated to either daily therapy with a home-based handheld comb device (group A, n = 17) or thrice-weekly hospital-based whole-body NB-UVB therapy (group B, n = 14) for 4 months, based on their preference. The primary and secondary outcomes were assessed at each follow-up, and appropriate statistical tools were used for analysis. Results: Of the 31 patients enrolled, 26 patients (study groups A/B: 15/11) completed the study. Primary outcome: Median percentage repigmentation of the representative patch in groups A and B were 51.35% and 63.85%, respectively (P = 0.64). The median size reduction of the representative patch in both groups was statistically significant (P < 0.05). The mean difference between “per protocol analysis” and “intention to treat” showed noninferiority. Secondary outcomes: Both groups were comparable on Lund and Browder score, patient global assessment and investigator global assessment scores, adverse events, color match, and change in the quality of life. The comparison group had a significantly greater number of missed sessions (P = 0.02). The majority of patients had a “good” response in both groups. Conclusion: Handheld NB-UVB comb device daily with a fixed dose of fluence was found to be noninferior with better compliance to standard whole-body NB-UVB therapy.

Introduction: The deposition of calcium in the skin is known as calcinosis cutis. It can affect any part of the body and can mimic soft tissue or bony lesions clinically. Aim: To describe the clinical and cytomorphologic features of calcinosis cutis on fine needle aspiration cytology smears. Materials and Methods: A total of 17 cases reported as calcinosis cutis on fine needle aspiration cytology were reviewed for the available clinical and cytological details. Results: The cohort included both adult and pediatric patients. Clinically, the lesions appeared as painless swellings of variable sizes. The common sites affected were the scrotum, iliac region, scalp, pinna, neck, axilla, elbow, arm, thigh, and gluteal region. Aspirate was chalky white, paste-like in all the cases. The cytologic evaluation revealed amorphous crystalline deposits of calcium along with histiocytes, lymphocytes, and multinucleated giant cells. Conclusions: Calcinosis cutis has a wide spectrum of clinical presentations. Fine needle aspiration cytology is a minimally invasive approach for diagnosing calcinosis cutis, thus eliminating the need for more extensive biopsy procedures.

Aims: The aim of this study is to compare and evaluate short-term outcomes of laparoscopy-assisted composite patch mesh repair versus laparoscopic intraperitoneal onlay mesh in small primary midline ventral hernias. Materials and Methods: Eighty consecutive patients with small (

Abstract People with acute COVID-19 due to SARS-CoV-2 infection experience a range of symptoms, but major factors contributing to severe clinical outcomes remain to be understood. Emerging evidence suggests associations between the gut microbiome and the severity and progression of COVID-19. To better understand the host-microbiota interactions in acute COVID-19, we characterized the intestinal microbiome of patients with active SARS-CoV-2 infection in comparison to recovered patients and uninfected healthy controls. We performed 16S rRNA sequencing of stool samples collected between May 2020 and January 2021 from 20 COVID-19-positive patients, 20 COVID-19-recovered subjects and 20 healthy controls. COVID-19-positive patients had altered microbiome community characteristics compared to the recovered and control subjects, as assessed by both α- and β-diversity differences. In COVID-19-positive patients, we observed depletion of Bacteroidaceae, Ruminococcaceae, and Lachnospiraceae, as well as decreased relative abundances of the genera Faecalibacterium, Adlercreutzia, and the Eubacterium brachy group. The enrichment of Prevotellaceae with COVID-19 infection continued after viral clearance; antibiotic use induced further gut microbiota perturbations in COVID-19-positive patients. In conclusion, we present evidence that acute COVID-19 induces gut microbiota dysbiosis with depletion of particular populations of commensal bacteria, a phenomenon heightened by antibiotic exposure, but the general effects do not persist post-recovery.

Abstract Globally 3 billion people are consuming water with moderately high concentrations of fluoride and arsenic. The development of a simple point of care (PoC) device or home device for the detection of fluoride/arsenic ensures safety before consuming water. Till date, lateral flow assay (LFA) based PoC devices can detect nucleic acids, viruses and diseases. An aluminium complex of rhodamine B functionalized oxacalix[4]arene (L) was designed to execute the LFA-based PoC device. Initially, Al3+ and Fe3+ ions were involved in complexation with the rhodamine B functionalized oxacalix[4]arene (L), resulting C 1 (L-Al3+) and C 2 (L-Fe3+) complexes respectively. The receptor L, as well as the probes (C 1 , C 2 ), were characterized thoroughly using mass spectroscopy, FTIR, NMR, and EA. C 1 and C 2 were further utilized as recyclable probes for the detection of aqueous fluoride (21 ppb) and arsenate (1.92 ppb) respectively. The computational calculation indicates that upon complexation, the spirolactam ring opening at the rhodamine B site leads to optoelectronic changes. The consistency of LFA-based portable sensing device has been tested with water samples, synthetic fluoride standards and dental care products like toothpaste and mouthwash with concentrations ≥ 3 ppm. Moreover, fixed cell imaging experiments were performed to ascertain the in-vitro sensing phenomena.

The present study was carried out at ICAR-Indian Agricultural Research Institute (IARI), New Delhi over two consecutive years (2020 and 2021) to evaluate the influence of conservation agriculture (CA) and nitrogen management strategies on wheat yield in an intensified maize (Zea mays L.)-wheat (Triticum aestivum L.)-mungbean (Vigna radiata L.) cropping system. Results indicated that grain and straw yields of wheat in CA plots were higher, reaching 4829 and 7231 kg/ha, respectively. However, these yields were statistically comparable to those obtained from conventionally tilled plots (4502 and 6611 kg/ha, respectively). Significantly higher wheat grain and straw yields were observed in plots receiving nitrogen fertilizer. Interestingly, the harvest index remained unaffected by both tillage practices and nitrogen management strategies. After two seasons of wheat cultivation, CA plots had significantly higher soil nitrogen fractions, including mineral, alkali-permanganate, potentially mineralizable, microbial biomass N and total nitrogen, compared to conventionally tilled plots. Moreover, all nitrogen-receiving treatments demonstrated significantly higher nitrogen fractions at both soil depths (0–5 and 5–15 cm) compared to the control. Notably, plots treated with urea super granules exhibited superior results in enhancing plant-available nitrogen. In conclusion, this study underscores the importance of CA and various nitrogen management strategies for increasing wheat crop yield and promoting plant-available nitrogen fractions in the soil. These findings provide valuable insights for farmers and researchers looking for sustainable and efficient agricultural practices to optimize wheat production and soil health.

Background: Inversion ankle injuries are extremely common, sometimes causing injury to the peroneus brevis tendon. If more than 50% of the tendon is injured, it oftentimes requires tenodesis to the adjacent peroneus longus tendon. Both Pulvertaft (PT) and side-to-side (SS) techniques have been used for joining the 2 tendons. The purpose of this study was to compare the strength and stiffness of these 2 techniques. Methods: Five matched pairs of cadaver ankle specimens were randomized to receive either an SS or PT tenodesis of the peroneus brevis to longus tendons. Following the tenodesis, the specimens were tested for failure load, displacement, energy absorbed at failure, and peak load. Stiffness was also calculated. Paired t tests were performed to detect differences between the 2 conditions. Results: There were no statistically significant differences between the SS and PT tenodesis for any of the metrics measured. For stiffness, the techniques were very similar (SS = 10.14 [4.35], PT = 12.85 [1.72]). Conclusion: There is no difference in failure load, displacement, energy absorbed at failure, peak load or stiffness between the PT and SS techniques for peroneal tenodesis. Level of Evidence: Level V, cadaver study.

Colorectal cancer (CRC) is one of the most deaths causing diseases worldwide. Several risk factors including hormones like insulin and insulin like growth factors (e.g., IGF-1) have been considered responsible for growth and progression of colon cancer. Though there is a huge advancement in the available screening as well as treatment techniques for CRC. There is no significant decrease in the mortality of cancer patients. Moreover, the current treatment approaches for CRC are associated with serious challenges like drug resistance and cancer re-growth. Given the severity of the disease, there is an urgent need for novel therapeutic agents with ideal characteristics. Several pieces of evidence suggested that natural products, specifically medicinal plants, and derived phytochemicals may serve as potential sources for novel drug discovery for various diseases including cancer. On the other hand, cancer cells like colon cancer require a high basal level of reactive oxygen species (ROS) to maintain its own cellular functions. However, excess production of intracellular ROS leads to cancer cell death via disturbing cellular redox homeostasis. Therefore, medicinal plants and derived phytocompounds that can enhance the intracellular ROS and induce apoptotic cell death in cancer cells via modulating various molecular targets including IGF-1 could be potential therapeutic agents. Alkaloids form a major class of such phytoconstituents that can play a key role in cancer prevention. Moreover, several preclinical and clinical studies have also evidenced that these compounds show potent anti-colon cancer effects and exhibit negligible toxicity towards the normal cells. Hence, the present evidence-based study aimed to provide an update on various alkaloids that have been reported to induce ROS-mediated apoptosis in colon cancer cells via targeting various cellular components including hormones and growth factors, which play a role in metastasis, angiogenesis, proliferation, and invasion. This study also provides an individual account on each such alkaloid that underwent clinical trials either alone or in combination with other clinical drugs. In addition, various classes of phytochemicals that induce ROS-mediated cell death in different kinds of cancers including colon cancer are discussed.

Introduction Nicotine dependence is known to be a chronic remitting and relapsing addictive disorder. Among cancer patients who smoke, nicotine addiction has been found to be more when compared with smoking healthy individuals. Smokerlyzer machine can be used to test smoking substance use and de-addiction services can be provided at Preventive Oncology units. The objectives of the study include: (i) To assess eCO using a Smokerlyzer hand-held machine and correlate it with the smoking status, (ii) To assess the cut-off value for smoking use, and discusses the benefits of this method. Methods In this cross-sectional study, healthy individuals at the workplace were tested for exhaled CO (eCO), which is used as a biological marker for monitoring the tobacco smoking. We discuss the feasibility of testing and its implications for cancer patients. The Bedfont EC50 Smokerlyzer machine was used to measure the concentration of CO in the end-tidal expired air. Results Among 643 study subjects, we found a statistically significant difference (P < .001) of median (IQR) eCO (measured in ppm) among smokers and non-smokers 2(1,5) vs 1(1,2). A significant and moderate positive correlation (Spearman rank correlation coefficient: .463) was observed between eCO and subjects who used cigarettes (measured in pack years). The ROC curve shows a cut off value for eCO as 2.5 with sensitivity 43.6% and 1 – specificity 2.76% (Specificity: 97.24%), which was rounded to 3. The area under the curve is 74.9%, which indicates a moderate discrimination performance of the test. The diagnostic accuracy of the test is 82.89%, which shows the proportion of correct test results. Conclusion Estimating eCO in health care settings will enable monitoring the smoking substance use which has important impact on clinical outcomes. In cancer hospitals, when the goal is complete abstinence a stringent CO cutoff in the range of 3-4 ppm should be used.